Science & Technology

Precision physical activity: A prescription for exercising in older adults

How many times have you committed to a new exercise program, only to dejectedly realize one day that a month has gone by, and you have completely forgotten about all those overly ambitious resolutions you had made? Fear not, this article’s goal is not to guilt trip you, but rather to highlight the need for personalized interventions that enhance physical activity according to individual needs.

In a world where physical inactivity affects an estimated 1.4 billion adults, addressing this global health challenge requires innovative strategies. Canada, with its rapidly aging population, faces a unique challenge: How to keep the baby boomer generation active and healthy after retirement.

Adrián Noriega de la Colina, a CIHR-Institute of Aging Fellow at McGill’s Neurological Institute-Hospital, and his team tackle this issue by proposing a roadmap that aims to decrease physical inactivity and reinforce adherence to consistent exercise in their recent publication.

“Of course pharmacological interventions are important, but I think one of the best and cheapest ways to enact prevention is through physical activity,” Noriega de la Colina said in an interview with The Tribune.

However, the traditional approach of general exercise guidelines often falls short, particularly for individuals with chronic conditions. Current clinical guidelines, such as the recommendation of 150 minutes of moderate exercise per week, result from population averages that do not take into account individuals’ diverse circumstances.

“There’s something that we [as physicians and researchers] are missing: We are either not communicating correctly, or we are not giving the patients what they need,” Noriega de la Colina noted.

Precision physical activity (PPA), which aims to tailor physical activity recommendations to individual needs by considering factors like age, sex, existing health conditions, and even living environments, is one solution. 

Noriega de la Colina and his team created a roadmap that provides guidance for the implementation of PPA. The starting point would be deep baseline phenotyping for a detailed understanding of an individual’s characteristics and limitations, thereby ensuring the maximal possible health benefits.

“A phenotype is a conjunction of characteristics that define an individual, such as age and sex, socio-demographics, any comorbidities, [and] baseline level of activity.” Noriega de la Colina said.

The collection of multiple phenotypes gives rise to clustered profiles, which doctors then compare against an individual’s unique characteristics. Clinicians can then provide more appropriate interventions to optimize health benefits based on what profile matches a patient’s characteristics best.

Clinicians can then provide more appropriate interventions to optimize health benefits based on the best match between a patient’s characteristics and the profile  multiple phenotypes

According to Noriega de la Colina, the proposed blueprint includes the following elements: How to start an intervention, how to maintain an individual’s engagement, and their preference of physical activity. All three components should be informed by factors such as socio-demographics, personal characteristics such as health conditions, and psychological determinants from perceived-barriers and self-motivation to one’s social and physical environment.

“So this [paper] is a framework for others to build on. And the idea would be that, through open science, we can collaborate more because the amount of data that you need for precision medicine is enormous,” Noriega de la Colina said.

PPA represents a paradigm shift in how clinicians and researchers approach the promotion of physical activity overall, particularly in aging populations. The ultimate goal is to provide customized therapy, where prescriptions for physical activity are as tailored as pharmaceutical treatments.

“Instead of saying ‘Go and walk 150 minutes and good luck,’ it would be better to be able to prescribe something much more suited for your needs,” Noriega de la Colina said. “Behavioural studies show that individuals have increased levels of compliance and adherence when they know specifically what they have to do.”

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